HomeMy WebLinkAboutBLDCI-16-007014-02 r
The Commonwealth of Massachusetts •
=yv_et City\Town of
_ (_ YARMOUTH
t •
New and Renewal Certificate of Inspection •
In accordance with the Massachusetts State Building Code,Section 110.7
Identify Name of Establishment Certificate No.
Issued to
Business Name:CAPE SHORE INN BLDCI-16-007014-02
Trade Name:CAPE SHORE INN
Identify property address including street number,name,city or town and county Certificate Expiration
Located at
793 ROUTE 28 04/01/2019
SOUTH YARMOUTH,MA 02664
Use Group Floor Occupancy Use Group Other
Classifications(s)
R-1 01st Floor. 8 R-1 Hotel/Motel/Boarding House/Transient 8 UNITS
MANAGERS
Allowable APARTMENT
LOBBY
Occupant Load 02nd Floor 10 R-1 Hotel/Motel/Boarding House/Transient 10 UNITS
This certificate of inspection is hereby issued by the undersigned to certify that the premise,structure or portion thereof as herein specified has been inspected for
general fire and life safety features. This certificate shall be framed behind glass and/or laminated and posted in a conspicuous place within the space as directed
by the undersigned. Failure to pose or tampering with the contents of the certificate is strictly prohibited
Name of Municipal Name of Municipal Mark Grylls Date of
Building Commissioner Inspection Q�/16)
Signature of Municipal Signature of Municipal Date of
Building Commissioner j Issuance
• Fee:$124.00
4aceiGFed/$7A0
B LD_Certoflnspection.rpt
o- .. ° .4FeN TOWN OF YARMOUTH
of ).,t BUILDING DEPARTMENT
% ' 1146 Route 28, South Yarmouth, MA 02664 508-398-2231 ext. 1260
APPLICATION FOR CERTIFICATE OF INSPECTION
May 1, 2018 PAYABLE UPON RECEIPT
(X) Fee Required 124.00
( ) No Fee Required
In accordance with the provisions of the Massachusetts State Building Code, Section 110.7, I hereby apply for a
Certificate of Inspectioon for the below-named premises located at the following address:
Street and Number: / 'I 3 r•tA;V. S C /
Name of Premises: (Ilk. Skf� Linty Tel: coir' 694-- CPv9
Purpose for which permit is used: r ilO Fe]
License(s) or Permit(s) required for the premises by other governmental agencies:
License or Permit RECEIVED Agency
MAY 232018
itai
PARTME ' '' /
by .�-6����
Certificate to be issued to • f°- l4 Tel: 508- 6 91 -7q 69
Address: '193 Moo.. Sf. caw '/a✓inou(vt , /1/44tic o1My
Owner of Record of Building S'A o-i Ka.1S A_ovr e,
Address IOS Lettv1/421}eti. S 3,,,,ik;.w,}akd f`1Pc 0/$o3
Present Holder of Certifical6 s _ o ; ' - - C_.
S Vly I Dom,/
Signature of person t whom Title n/
Certificate is issued r his agent 5 (2 3 ((d"
Date/
Email Address: oer `SKANSWl _ L
a h+teti '• tows.
- Instructions: Make check payable to:J Town of Yarmouth
1146 Route 28, South Yarmouth, MA 02664
Return this application to: Building Inspector's Office
Please note: Application form with accompanying fee must be submitted for each building or structure or part thereof
to be certified. Application must be received before the certificate will be issued. The building official shall be
notified within ten(10)days of any change in the above information.
PLEASE SEND US A COPY OF YOUR WORKER'S COMPENSATION INSURANCE FORM WITH THIS
APPLICATION OR WE CANNOT ISSUE YOUR CERTIFICATE OF INSPECTION.
Certificate of Inspection# PLDC'Zm' -t 90/Y- 07-.
4/1/2018-4/1/2019